Hello Guest, Welcome to Apnea Board !
As a guest, you are limited to certain areas of the board and there are some features you can't use.
To post a message, you must create a free account using a valid email address.

or Create an Account


New Posts   Today's Posts

[Diagnosis] Help Interpreting In-Home Study
#1
Help Interpreting In-Home Study
Hey everyone,

I hope this is an acceptable request. I just got the results of my in-home study with Luna, and unfortunately it gave me a report, and no consultation. I'm a little overwhelmed and I'm hoping that anyone here can provide some insight to at least understand things a little more. I ordered the study after struggling with sleep for a while. Frequent wake ups were a problem, as well as feeling tired basically every morning. Things came to a head when I've been waking up gasping for air a little bit more often.

In addition to just general interpretations of the results, of which I've attached, I'm looking for answers to:

1. Is there anything in particular I need to be looking at that point to answers/results?

2. Does the diagnosis, treatment, and CPAP prescription match the results of the test? AKA, is it severe enough to warrant CPAP?

3. Was the in-home study enough or should I take a look at a more intensive lab one?

4. Is the recommended equipment appropriate? (mostly, the recommended machine, mask, etc.)

ANY help or feedback at all is very, very appreciated.


-----
Moderator Action: Link Removed (attachment included a link to Supplier #1)
To maintain our status as an educational organization, the only commercial links allowed in this forum are to CPAP-related manufacturer websites. This is stated in the Apnea Board Rules with details given in the Commercial Links Policy section.
-----
Post Reply Post Reply



Donate to Apnea Board  
#2
RE: Help Interpreting In-Home Study
Hi, there.  I am but one voice, so please read, consider, and then await more opinions.  There are at least six people here routinely who know about six times what I know and understand.

Your machine detected mild apnea.  It found that you had the most problems when you were on your back.  That's how it works for most everyone who has apnea.  Even those doing well with no recorded apnea do 'worse' on their backs.  Sleeping on one's back is probably best avoided, and it gets worse over time.

Often apnea is associated with our chins falling forward.  Even when on our sides, most of us tuck our chins down toward our chests.  That always restricts the airway, even if it doesn't close it off completely.  So, lying on our backs, and chin tuck are not great....often they go together.

You lost oxygen concentration at times, and that would be during the longest apneas as you would guess.  Even so, they weren't what I would call 'bad' desaturations (desats for short).  Not that any desats could be termed 'good', but yours were not prolonged or bad.  My own was down near 85% a couple of times during my sleep lab at a clinic.  That's 'bad'.

I don't know much about your health, your fitness level, how well or how long you sleep, what you eat, what your BMI is, your happiness index, if you are in a good and committed relationship....I know nothing that would suggest you might benefit from PAP therapy except what we can see from your recent evaluation.  My guess is that yes, you would probably benefit from PAP, but maybe there's something else about 'you' these past few months that makes this apnea impermanent.  Dunno...you tell me.

How do you feel during the day?  Have others who love you begun to tell you that you are changing personality, mood, energy level, fun to be with, etc?  Maybe PAP on the short term will help, but it might have to be long term...as in...forever.

I wouldn't turn up an opportunity to have a formal polysomnography.  It's the gold standard and would be more definitive than your in-home evaluation.

Also Gold Standard is the RESMED AS10 Autoset or AirCurve machine that is fully automatic and can auto-titrate you as you sleep.  The mask is a wash; it depends on the individual and what works, what fits best, what interferes less with sleep.  You have to decide on which mask works for you, and that generally means a trial period.

Good luck!!
Post Reply Post Reply
#3
RE: Help Interpreting In-Home Study
Second the Resmed AS10 AUTOSET. Since the machine is ar the heart of your treatment, get the best. It will be your life from now on.
CPAP is a journey like “The Wizard of Oz”. It’s a long slow journey. You will face many problems and pick up many friends along the way. Just because you reach the poppies, it doesn’t mean you are in Kansas. 
Post Reply Post Reply
#4
RE: Help Interpreting In-Home Study
Welcome. Your request is perfectly appropriate. Your prescription is for an auto CPAP with a pressure range of 4cm H2O to 20cm. That means a machine that will adjust it's pressures to match your needs. It is the best treatment for obstructive sleep apnea. The best machineis the Resmed airsense 10 autoset or airsense 10 autoset for her. Given that your prescription reads dispense as written, an auto CPAP is what you should be given. Don't settle for less. The prescribed pressure range is not optimal for most. You will probably feel starved for air at 4. Stating with a range of 6-20viw better. Let us know when you get your machine and we can help you with the best settings. Be sure to get and SD card for the machine so you can see detailed data. If the supplier does not provide one any SD card up to 32GB will do. You will then want to download free OSCAR software (see top of this page) so you can post data here. That's more than enough for now. Please feel free to ask any questions.
Post Reply Post Reply



Donate to Apnea Board  
#5
RE: Help Interpreting In-Home Study
I agree with menentaria's interpretation of mild obstructive apnea. Your home study shows no apnea is present, but your respiratory volume drops and minor oxygen desaturation was observed, with a median of 95% and minimum of 92%. By itself, I would not consider this study conclusive for obstructive apnea, and the questions about how you feel, your fatigue level and tiredness are what I would fall back on to decide.

I'm not a big fan of clinical PSG as they are expensive tests and uncomfortable. You have a prescription for auto CPAP if you choose to use it, but your results are far from alarming, and the decision comes down to whether you think you would benefit. If you are going to use insurance, I suspect they will want a clinical study to verify medical need as this one is borderline inconclusive. Under most insurance standards, this mild AHI would not qualify for treatment without comorbid symptoms. If you are going out of pocket, Supplier #33 offers lower prices, and you can even acquire lightly used machines at a lower price. I would not go with the full face mask suggested here, but use a nasal pillows mask which is lighter, less obtrusive and more comfortable assuming you breath normally through your nose.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
Optimizing Therapy
Organize your OSCAR Charts
How To Attach Images And Files to your posts
How To Deal With Equipment Supplier
Mask Primer
Beginner's Guide to Sleepyhead

INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
Post Reply Post Reply
#6
RE: Help Interpreting In-Home Study
(07-26-2019, 11:13 AM)mesenteria Wrote: Hi, there.  I am but one voice, so please read, consider, and then await more opinions.  There are at least six people here routinely who know about six times what I know and understand.

Your machine detected mild apnea.  It found that you had the most problems when you were on your back.  That's how it works for most everyone who has apnea.  Even those doing well with no recorded apnea do 'worse' on their backs.  Sleeping on one's back is probably best avoided, and it gets worse over time.

Often apnea is associated with our chins falling forward.  Even when on our sides, most of us tuck our chins down toward our chests.  That always restricts the airway, even if it doesn't close it off completely.  So, lying on our backs, and chin tuck are not great....often they go together.

You lost oxygen concentration at times, and that would be during the longest apneas as you would guess.  Even so, they weren't what I would call 'bad' desaturations (desats for short).  Not that any desats could be termed 'good', but yours were not prolonged or bad.  My own was down near 85% a couple of times during my sleep lab at a clinic.  That's 'bad'.

I don't know much about your health, your fitness level, how well or how long you sleep, what you eat, what your BMI is, your happiness index, if you are in a good and committed relationship....I know nothing that would suggest you might benefit from PAP therapy except what we can see from your recent evaluation.  My guess is that yes, you would probably benefit from PAP, but maybe there's something else about 'you' these past few months that makes this apnea impermanent.  Dunno...you tell me.

How do you feel during the day?  Have others who love you begun to tell you that you are changing personality, mood, energy level, fun to be with, etc?  Maybe PAP on the short term will help, but it might have to be long term...as in...forever.

I wouldn't turn up an opportunity to have a formal polysomnography.  It's the gold standard and would be more definitive than your in-home evaluation.

Also Gold Standard is the RESMED AS10 Autoset or AirCurve machine that is fully automatic and can auto-titrate you as you sleep.  The mask is a wash; it depends on the individual and what works, what fits best, what interferes less with sleep.  You have to decide on which mask works for you, and that generally means a trial period.

Good luck!!

(07-26-2019, 11:32 AM)Sleeprider Wrote: I agree with menentaria's interpretation of mild obstructive apnea.  Your home study shows no apnea is present, but your respiratory volume drops and minor oxygen desaturation was observed, with a median of 95% and minimum of 92%.  By itself, I would not consider this study conclusive for obstructive apnea, and the questions about how you feel, your fatigue level and tiredness are what I would fall back on to decide.  

I'm not a big fan of clinical PSG as they are expensive tests and uncomfortable.  You have a prescription for auto CPAP if you choose to use it, but your results are far from alarming, and the decision comes down to whether you think you would benefit.  If you are going to use insurance, I suspect they will want a clinical study to verify medical need as this one is borderline inconclusive.   Under most insurance standards, this mild AHI would not qualify for treatment without comorbid symptoms.  If you are going out of pocket, offers lower prices, and you can even acquire lightly used machines at a lower price.  I would not go with the full face mask suggested here, but use a nasal pillows mask which is lighter, less obtrusive and more comfortable assuming you breath normally through your nose.


Thank you both for your reply, as well as those not quoted. It's really less intimidating to look at with assistance.

To answer mesenteria's questions: as far as it being impermanent, i would say that I've put on a fair amount of weight over the past 2 years, but it has been progressive, over that time. My quality of sleep has been pretty poor, as far as just many wakeups. I do have a sedentary job and do not exercise often. So I'm not sure if these things are just contributing factors or causes. I suppose its hard to hell. I can tell you, as I will note later, that I am tired almost always.

To sleeprider: to be quite honest with you, I cannot remember the last time I woke up feeling rested, regardless of amount of sleep I got. It could be 4 hours, or 8 hours, and I basically feel the same. I would say outside of that, my primary concern is waking up gasping for air which for me, has been extremely scary. I have a high deductible and I may go outside insurance, which is kind of why, I suppose, the "mildness" of the results has me unsure of next steps, especially in the way of a second opinion. Though again, health comes first. I asked for a consultation with the sleep doctors at Luna, but they have been...unhelpful, thus far.

If anyone else has opinions, feedback, or interpretations, I'd love to hear them.
Post Reply Post Reply


Possibly Related Threads...
Thread Author Replies Views Last Post
  new sleep study titration?? restful 4 150 08-12-2019, 11:03 PM
Last Post: restful
  Resmed apnealink home sleep test issues greywyvern 5 140 08-12-2019, 02:21 PM
Last Post: Mogy
  My sleep study report : any recommendations SunHu 1 104 08-12-2019, 12:25 PM
Last Post: OpalRose
  New user- 2 week CPAC results + sleep study kiwi man 38 498 08-11-2019, 09:41 AM
Last Post: pholynyk
  Dr wants another study ShariMarie 33 874 08-01-2019, 11:13 AM
Last Post: SarcasticDave94
  [Treatment] help interpreting OSCAR Wcsleep 4 174 08-01-2019, 08:38 AM
Last Post: Crimson Nape
  Interpreting OSCAR data Wcsleep 1 134 07-30-2019, 08:26 PM
Last Post: DeepBreathing


New Posts   Today's Posts






About Apnea Board

Apnea Board is an educational web site designed to empower Sleep Apnea patients.